Provider Demographics
NPI:1851820203
Name:ZLATOPOLSKY, MAXIM ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:MAXIM
Middle Name:ALEXANDER
Last Name:ZLATOPOLSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MAX
Other - Middle Name:ALEXANDER
Other - Last Name:ZLATOPOLSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:22 TURTLE CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-8591
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 TURTLE CREEK CIR
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-8591
Practice Address - Country:US
Practice Address - Phone:419-825-5151
Practice Address - Fax:419-825-5901
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301500775207R00000X
OH35.140040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine